Health Bill - Standing Committee E

[Mr. Eric Illsley in the Chair]

Health Bill

Caroline Flint: I beg to move,
That—
(1)during proceedings on the Health Bill the Standing Committee shall (in addition to its first meeting at 10.35 a.m. on Tuesday 6th December) meet—
(a)at 3.55 p.m. on Tuesday 6th December;
(b)at 9.00 a.m. and 1.00 p.m. on Thursday 8th December;
(c)at 10.35 a.m. and 3.55 p.m. on Tuesday 13th December;
(d)at 9.00 a.m. and 1.00 p.m. on Thursday 15th December;
(e)at 9.00 a.m. and 2.00 p.m. on Tuesday 20th December;
(f)at 10.35 a.m. and 3.55 p.m. on Tuesday 10th January;
(2)the proceedings shall be taken in the following order: Clauses 1 to 8; Schedule 1; Clauses 9 and 10; Schedule 2; Clauses 11 and 12; new Clauses and new Schedules relating to Part 1; Clauses 13 to 15; new Clauses and new Schedules relating to Part 2; Clauses 16 to 30; new Clauses and new Schedules relating to Part 3; Clauses 31 to 52; new Clauses and new Schedules relating to Part 4 (except new Clauses and new Schedules relating to the accounts of health service bodies and the auditing of such accounts); Clause 54; Schedule 4; Clause 55; Schedule 5; Clauses 56 and 57; Schedule 6; Clauses 58 to 66; Schedule 7; Clauses 67 and 68; new Clauses and new Schedules relating to Part 5; Clauses 69 to 71; new Clauses and new Schedules relating to Part 6; Clause 53; Schedule 3; new Clauses and new Schedules relating to the accounts of health service bodies and the auditing of such accounts; Clauses 72 to 76; Schedules 8 and 9; Clauses 77 to 80; remaining new Clauses and new Schedules; remaining proceedings on the Bill;
(3)the proceedings shall (so far as not previously concluded) be brought to a conclusion at 7.00 p.m. on Tuesday 10th January.
I am pleased to move the programme motion because, as a result of discussions through the usual channels before it met, the Programming Sub-Committee did not need to vote on it. That indicates that all parties were pleased with it.
You will be aware, Mr. Illsley, that we plan to continue, if necessary, until 20 December. The Lord Commissioner of Her Majesty’s Treasury, my hon. Friend the Member for Lincoln (Gillian Merron), has placed no knives on our debates; we want to ensure that everyone has ample time to discuss the important parts of the Bill. Without further ado, I commend the motion.

Andrew Lansley: I welcome you to the Chair, Mr. Illsley. It will be a pleasure to serve under you and your fellow Chairman. I do not recall having had the pleasure of serving under your chairmanship before, but I look forward to doing so.
I am grateful to the Minister for moving the programme motion. It seems tight but achievable so long as we constrain ourselves to the subject in hand rather than speaking of extraneous matters. The Minister did not point out that we have nine  substantive subjects to discuss, although one or two loom somewhat larger than the others. However, we must ensure that we have time to discuss other matters that are less controversial but none the less significant.
I am comforted by the fact that the same will not be done with this Bill as happened with the Health and Social Care (Community Health and Standards) Act 2003. I had the privilege of serving on the Committee that considered that legislation, and I remember that the general medical services contract was added on Report rather than being discussed in Committee. For example, we shall have the opportunity to discuss the general ophthalmic services contract in Committee. I hope that it will be given at least the one and a half hours that was allocated to discussing the general medical services contract. Subsequent events have demonstrated the value of discussing such matters in Committee before implementation exposes all the problems.
I know that the eyes of the nation are upon us today—little else is happening. People will be looking to us to proceed swiftly to discuss Part 1, which is a matter of great interest. I am happy to say that we accept the programme motion; we want to get on with the business at hand.

Steve Webb: Thank you, Mr. Illsley, and good morning. This is the first time that I have served under your chairmanship, and I look forward to serving under you and your colleague.
We welcome the flexibility that the programme motion gives us. It will allow us time to discuss Part 1, which has attracted a great deal of attention. However, many members of the Committee will have received representations—for example, about the proposed changes to optometry services. If it seems as though important issues will be squeezed out, the Sub-Committee has the opportunity to revisit the motion. However, to begin with, the flexibility that it gives us is welcome.
One of my worries is that one issue can dominate debates in Committee and that other important changes receive little scrutiny as a result. If we do not scrutinise them in Committee, the danger is that those one or two headline issues will dominate time on Report. That would be regrettable, as further important issues are dealt with later in the Bill. I give you my assurance, Mr. Illsley, that we will not seek to protract proceedings. We will make our points as succinctly as possible and then sit down.

Andrew Murrison: It is a pleasure to serve under your chairmanship, Mr. Illsley. I was a member of the Programming Sub-Committee, and I should like to correct the Minister’s assertion that we were “pleased” with the programme. We were in so far as we do not have the knife; that is welcome given that most of the public controversy rests with the initial clauses of the Bill. However, it would be more accurate to say that we were content with the total time available. We must get to the important later clauses, particularly those relating to ophthalmic services and  pharmacy. It would be regrettable if the emphasis on smoking, controversial though that is, were to detract from our consideration of those matters.

Question put and agreed to.

Eric Illsley: I must now outline one or two arrangements. I remind the Committee that there is a money resolution in connection with the Bill. Copies are available in the Room. I should also like to remind hon. Members that adequate notice must be given of amendments and that, as a general rule, my fellow Chairman and I do not intend to call starred amendments, including any that may be reached during an afternoon sitting of the Committee.
May I also point out at this juncture that starred amendments Nos. 75 and 76 have been printed in error in the name of the Minister rather than in those of the hon. Members for Northavon (Steve Webb) and for Bristol, West (Stephen Williams)? Hon. Members are free to remove their jackets as they wish when I am chairing the Committee. It might be necessary to seek permission from my fellow Chairman.

Clause 1 - Smoke-free premises, places and vehicles

Question proposed, That the clause stand part of the Bill.

Andrew Lansley: I was rather hoping that, in the course of her comments on the clause, the Minister might explain to us the underlying principles of the Bill. Nevertheless, let us get straight to it. The purpose of the clause is to bring into law the prohibition on smoking in certain premises. From that prohibition will flow the discussion about how it is to be defined and how exemptions are to be made.
I suppose that, at this stage, I want to explore two things. The first is the Government’s view on the structure of the prohibition. On what evidence have they based it? The second is the consultation process on the policy that led to the introduction of the legislation. Before we get into the detail, it would be sensible to understand where the Government are coming from.
The Committee will recall the discussion on Second Reading. I want to make it clear that our objective is to achieve a dramatic reduction in the incidence of smoking in public places, thereby contributing to a reduction in the prevalence of smoking. There were substantial reductions in the 1970s and 1980s, but the trend has slowed since then and there are serious problems, particularly the prevalence among younger people, which has barely reduced in the past four or five years. The Minister will know that one of the issues is the extent to which young people starting work are able to smoke in the workplace. The evidence clearly suggests that if we can reduce opportunities for smoking at work, we can reduce the overall prevalence of smoking among young people, with consequential major long-term health gains.
At the time of the publication of the White Paper, the Scientific Committee on Tobacco and Health set out clear summary evidence of the negative health  impacts of smoking in relation to lung cancer and coronary heart disease. As I said on Second Reading, the most significant part of that in terms of changing the character of the debate on smoking—especially passive smoking—was the increasing evidence of the impact of relatively small amounts of environmental tobacco smoke on myocardial infarction, or a heart attack.
Occasionally I must wear these glasses, and not just because we shall later be discussing general ophthalmic services. I am not trying to curry favour with the optical professions. The Minister will be aware of the interesting paper published in the BritishMedical Journal on 24 April 2004, which relates to a six-month period in the town of Helena, Montana. That geographically isolated community had a local byelaw that prevented smoking in all public places. During the six months when that law was in force, the number of admissions to hospital for heart attacks fell significantly from an average of 40 admissions during the same six months of the preceding year to 24 admissions during the time the law was in effect. When the byelaw was subsequently challenged in a court and suspended, the rate of attendances at hospital for heart attacks rose again.
It is increasingly clear that relatively modest amounts of exposure to second-hand smoke can have significant impacts on health, especially where coronary heart disease is concerned. For some, second-hand smoke can have a substantial impact on their likelihood of having a heart attack. We must be aware of the benefits of what we are trying to achieve. This is not a matter of nuisance. I preface some of the arguments that my hon. Friend the Member for Westbury (Dr. Murrison) and I shall make later by stating that we are not talking about the nuisance effect of smoke; we are talking about the health effects of smoke. This is a Health Bill.
One of the central matters that has been in our minds is the strange circumstances of the Government’s publication last November of a White Paper that was supposed to be about health. Published evidence to which I have just referred illustrates the health impacts of second-hand smoke and shows the necessity of there being a means by which we can dramatically reduce the prevalence of smoking. However, the proposal that was put into the public health White Paper appeared to be geared more to questions related to the nuisance value of smoke to people eating meals in restaurants or pubs than it did to evidence relating to health.
Of course, we understand that a balance must be struck. It is an obvious, simple fact that if we were, somehow, able to ban smoking entirely, we would reduce the negative health impacts dramatically. About 23 per cent. of premature mortality among men is in some way related to smoking. However, we cannot bring in a complete ban because smoking is legal and has been for a long time. Many people are habituated to smoking, and we are striking a balance  between their liberty to smoke and the impact that that has on others. Those are the balances that we shall have to strike in the course of this debate.
The Government do not seem to have struck a balance at all, either geared to public opinion or to health effects. Public opinion research that I have seen seems to point to the kind of conclusions that my colleagues and I have reached. The public’s view is that workplaces and restaurants should be smoke-free but that public houses are something of an exception. Even on that matter, public opinion has moved sharply to a point where they wish pubs, generally, to be smoke-free except for specific rooms or areas that are designated for smoking. The largest number—although not a majority; it is something less, at 47 per cent.—in the last survey that I saw suggested that that was where the greater number of the public pitch their tent. There is no major public view that a balance should be struck whereby pubs are either smoking with no food or non-smoking with food.
That is a strange conclusion that the Government reached last November and then put forward. It was reflected, as I am sure the Minister will remind her colleagues many times, in the Labour party manifesto. If that had been the end of the matter, the Government would have proposed legislation based on their manifesto and would not have done anything else about it, but they did not. They consulted.
On 20 June, the Government issued a consultation. It is reasonable to ask what the point of that consultation was. Was it to find out specific details regarding enforcement and implementation? No; it was, on the face of it, to establish whether the proper balance had been struck with the proposed policy. We know what was going on: the new Secretary of State and team at the Department of Health very much wanted to move away from the policy that they had been left with to one that made more sense in health terms. That is not surprising considering that they were receiving advice from the chief medical officer who, as he recently made clear in his evidence to the Select Committee on Health, was strongly of the opinion, in his annual reports from 2002 to 2004, that there should be a comprehensive ban on smoking in all enclosed public places and that anything else would be substantially less beneficial.
It is not surprising that Ministers might want to reflect that professional advice in policy, so they had a consultation—but was it real? What was it intended to allow? I understand that there were 57,000 responses, 90 per cent. of which opposed the partial ban that the Government propose. What kind of response to a consultation would it take for the Government to change their mind about a policy that they subjected to consultation? Does it take 100 per cent? Are the Government prepared to proceed with opposition of anything up to 99 per cent? That is odd. The Minister will have to explain why they have proposed legislation of a structure that is clearly opposed by expert bodies and regarded as nonsensical by the public.

Andrew Murrison: Does my hon. Friend agree that if the Government run consultations that are seen to be a sham, it destroys all future consultations because the public and organisations will see that all the input that they give in good faith simply will not be taken seriously? The figure of 90 per cent. is overwhelming; it is extraordinary that the Government are not listening on that. I am sure that my hon. Friend will agree that the cost of such exercises is an issue for concern if the Government simply ignore them.

Andrew Lansley: I am grateful to my hon. Friend. That is exactly right. You would think it out of order, Mr. Illsley, if we were to talk about other consultations which, frankly, seem to be bogus, but that seems to be a continuing feature. The medical profession and people across the NHS are heartily tired of the extent to which they are engaging in bogus consultations on matters on which the relevant decisions seem to have been taken in advance.

Steve Webb: I am interested to see the importance that the hon. Gentleman attaches to the consultation that the Government have just undertaken. Why is he choosing selectively from the results of that consultation? Did it not also show that the public rejected an exclusion for private clubs, which he supports?

Andrew Lansley: I was not trying to represent the whole of those consultation responses, to which we will return when we discuss other issues. Clearly, we have to strike a balance. I am not saying that the results of the consultation must be the only basis on which we make our judgments; I am asking on what basis the Government entered into the consultation. It is obviously intended to inform what we do, and I shall have to make my judgments, as the hon. Member for Northavon will have to make his, and as the Minister will have to do for the Government. I want to know why the Government proceeded with the consultation, given the broad opposition to the structure of the partial ban that they propose. If the consultation was real, what have the Government done to reflect the responses in their policy?
I shall now discuss the structure of the benefits associated with the legislation as set out in the regulatory impact assessment. The Minister will recall that the RIA considered what benefits are likely to accrue from the partial ban that is being proposed. I am sure she will say that the ban will cover 99 per cent. of workplaces, the implication being that 99 per cent. of the benefit will be derived because 99 per cent. of workplaces are covered. What she does not take into account is the simple fact that more than one in two workplaces is already smoke-free, and that a higher proportion of the rest have designated smoking-only areas, the number of which is declining dramatically. Members of the Committee will know that more employers are coming to the conclusion every day that they should move to a work-free—[Laughter.]—a smoke-free workplace for health and safety reasons and because of their responsibilities towards their employees.
Many of the benefits that would be derived from workplaces becoming smoke-free are already being gained, so the question is what additional benefits are to be gained by introducing a smoking ban. The RIA highlights that fact, drawing the broad conclusion that a comprehensive ban would have the benefit of reducing the number of deaths by about 2,300, by my reckoning, as a result of the reduction in second-hand smoke. The partial ban would lead to a benefit that is only just over half that figure, not a figure that is only 1 per cent. away from the benefit of a full ban. Ministers must therefore tell us why they believe that we should engage in this major, complicated regulatory exercise. The costs of enforcing a partial smoking ban are higher than the costs of enforcing a comprehensive smoking ban, yet the Government propose to derive only half the benefit.

Andrew Murrison: Does my hon. Friend agree that the RIA is quite controversial, particularly since Professor Konrad Jamrozik’s paper, which was published in the British Medical Journal earlier this year, suggested that passive smoking at work accounted for a total of 617 deaths a year—a fairly precise figure—and at home, interestingly, for 10,700 deaths a year?

Andrew Lansley: I am grateful to my hon. Friend for mentioning that because the evidence set out by the Scientific Committee on Tobacco and Health related to various studies, many of which compellingly describe the impact of second-hand smoke on health and the likely mortality resulting from it. However, the studies overwhelmingly involved people with partners, spouses or family members who smoke or people who are persistently exposed to second-hand smoke at work.
There are extrapolations. I made a point earlier about the impact of modest exposure to second-hand smoke on coronary heart disease. It is significant, because initial evidence suggests that there is no linear relationship between exposure to second-hand smoke and the impact on mortality and morbidity, particularly where coronary heart disease is concerned. It is a non-linear relationship, and therefore modest exposure to second-hand smoke is one of the issues that we have to address. That is why I have no doubt that our objective should be to try to reduce sharply the incidence of smoking in all enclosed public places. The debate is simply about how we get there and the mechanisms involved.
The point that I want to establish at the outset is why the Government have gone down such a path. Why have we ended up in a position where the origin of the policy appears to have more to do with satisfying competing arguments inside Government than the health needs of the country? We seem to have had second thoughts—perhaps even third or fourth thoughts—set out among Ministers in the course of this year, on which they appear to have been frustrated and unable to act. The chief medical officer made it perfectly clear to the Health Committee that he did not agree with the Government’s policy, and said:
“I think it is rare for the Government to ignore the advice of its Chief Medical Officer or to fail to act on it. This is the first situation I have encountered in the seven years I have been in post when this has happened.”
The Minister has to explain why we are in this position at all.
The regulatory impact assessment, if we are to believe it, shows that the Government’s proposals will achieve barely half the potential benefits of a ban, with all or more of the enforcement costs and more of the ensuing complications and difficulties for the public. There is also limited evidence of the certainty of those benefits. Although I am taking the mid-point of the Government’s estimates, it is entirely possible that, as the Government’s regulatory impact assessment contemplates, the benefits for customers exposed to second-hand smoke may be negligible as a consequence of the changes. We need to be clear about what we are setting out to do.
So with clause 1, the purpose of which is to introduce the overall prohibition, although we might come on to one or two detailed points our main purpose is to examine what the Government are setting out to do. How did they come to this policy and how do they justify the fact that they will not deliver the benefits of a reduction in smoking, which are really needed?

Steve Webb: It seems appropriate to use clause 1, which introduces part 1 of the Bill, to make a short number of observations about the general strategy for the smoking ban that the clause will enable to be brought into force. It is helpful to say at the start that a number of the amendments that we will discuss later will try to make the best of a bad job. Our preference would have been the total ban that was in our manifesto and remains our policy to this day. It is worth stressing that, because later this morning and beyond some of the things that we suggest may not be consistent with a total ban. We will be trying to make a partial ban more effective.
I want to place on the record at the start my clear commitment and that of my hon. Friend the Member for Bristol, West to a total ban in line with our manifesto. The reasons for that have been eloquently expressed by the hon. Member for South Cambridgeshire (Mr. Lansley), who rightly pointed out that the maximum benefit from the Bill, in terms of the Government’s cost-benefit analysis, would come from a total ban. I find it puzzling, therefore, that he supports a different partial ban, which produces fewer benefits.

Andrew Murrison: At this early stage, will the total ban in the hon. Gentleman’s treatise cover cannabis? I understand that his party’s policy is to liberalise the use of cannabis, and he did not quite clear that up on Second Reading.

Steve Webb: The hon. Gentleman seems rather obsessed with the subject of cannabis; perhaps we should discuss that. Interestingly, clause 1(2)(a) states that
“‘smoking’ refers to smoking tobacco or anything which contains tobacco, or smoking any other substance”
so that is within the scope of the Bill. Our support for the Bill incorporates anything else that might be smoked in enclosed public places as well.
We are concerned—there is some common ground with the Conservative spokesman in this respect—about the welfare and health and safety of people who work in enclosed public places. It is as simple as that. As far as we are concerned—a number of my colleagues have made this point to me quite forcefully, and I agree with them—this is not about whether we approve or disapprove of what people do, for example, in their own homes; it is about places where that action has a consequence for other people. Arguably, part 1 of the Bill might usefully have been a health and safety measure brought in by another Department, because that is very much the way in which we approach it.
People sometimes say that the issue does not matter because those who work in smoky environments could choose to work somewhere else. In fact, that is arguable. If a town has one bar and it is a smoky bar, the people who work there may not be able to find other employment, but even if they could, from a health and safety point of view why should they have to? If asbestos was found in the roof here, we would not say, “It’s not a problem. Let’s go and use Committee Room 13.” We would say that it was bad for the health of the people who work here and sort out the health and safety problem. That is the approach that Liberal Democrat Members take. My liberty to smoke is not an unlimited liberty; it is limited by the impact of my exercise of that liberty on other people. We believe that that applies whether or not food is being served and whether or not the premises in question are a private members’ club. Such exemptions make no sense if we view the issue as one of health and safety.
There is an advantage to the way in which clause 1(2)(a) is drawn. As I said, it states that “smoking” relates not merely to tobacco but to other substances. Clearly, it will be a great deal easier if the enforcement authorities do not have to inspect the contents of the cigarette to try to work out exactly what it is. If smoke is coming from the substance, that is sufficient to provide for a ban.
No doubt we shall discuss the place of public opinion in all this; indeed, we have had some selective readings of public opinion already. Where health and safety is concerned, we should be leading public opinion, not following it. I believe that there is momentum in public opinion in the direction of a total ban and that there is evidence from other countries that when bans are introduced, they become popular very quickly and few people ever want to turn the clock back. The Government should have the courage of their convictions and lead public opinion in the interests of the health and safety of workers, not follow public opinion and be afraid of the focus groups.
I have described the framework within which we approach the Bill, and the lens through which we shall assess any amendments tabled. We hope that, by the  end of our process of scrutiny, we will have a Bill that generates more benefits for people who involuntarily are subjected to passive smoking and its consequences.

Caroline Flint: Having heard the two previous speakers, I am grateful for this opportunity to outline further what we said on this matter on Second Reading. The contribution from the hon. Member for South Cambridgeshire was interesting, because, listening to it, one might have assumed that he supported a total ban. However, based on what we heard on Second Reading and in his contribution today, it is clear that that is not the case, and when we consider the amendments, we shall see that it clearly is not the case. It is interesting that the hon. Gentleman uses an argument used by those who support a total ban, but then steps back from the brink. It is not clear whether Conservative Members support any legislation to impact on smoking in public places.
Let me recap on why the Government have reached this position. First, 1.2 million people have stopped smoking since 1998. That is a good example of how we are building on the progress that has been made over decades in public awareness of the dangers of smoking both to those who smoke and to those exposed to second-hand smoke. The Government should get some credit for building on those reductions through our anti-smoking campaigns, particularly on exposure to second-hand smoke, aimed not just at smokers but at families with children.

Steve Webb: The Minister has fairly characterised the further reduction of just over 1 million smokers as being part of a long-term trend, while mentioning what the Government have done. However, what would have been the counterfactual, supposing that there had been a do-nothing Government? Given a long-term trend of so many hundreds of thousands every few years, what would have happened over an eight-year period? How many fewer smokers would we have expected anyway, and how many can we ascribe to Government intervention? How much would have happened if the Government had stood by and watched? Some information now, or at some point, would indicate the effectiveness of the Government’s policy.

Caroline Flint: I am happy to write to the hon. Gentleman on that issue. Smoking cessation sessions are available through the NHS, and I can provide details on the number of people who have quit as a result of being involved in them. Nicotine replacement patches are available at those sessions. Alongside that, Government support for getting the message across in relevant ways to different sections contributes to the underlying trend. Importantly, Mr. Illsley, we have to do further work with some of the harder-to-reach individuals and communities. We are not making as much impact with them as we want.
I cited, on Second Reading, an interesting article that I read about some young women who were worried about giving birth to a heavy baby. They thought that that would add to the pain of childbirth and that smoking would create a low birthweight baby and, therefore, less pain. The fact that some young  women think that demonstrates that we have to listen to and understand people’s reasons for not giving up. We should then try to engage differently with them; for example, with that group of young women by reassuring them about pain relief in childbirth. Equally, in our recent adverts aimed at young people we chose to give a social message rather than a health message. It was about how people feel about others, perhaps when looking for a new partner in life, and has been successful among young people.
In 1996, smoking was in fact increasing to 13 per cent. among 11-15 year olds. I feel that we have contributed to reducing that to 9 per cent. by 2004. That is one example; I am happy to write further on where Government intervention and the good work by primary care trusts and others has affected the trend.

Andrew Lansley: On that point, the Minister will no doubt know that the figures from which she quotes also show that in 1999, 9 per cent. of youngsters aged 11-15, were recorded as being smokers. It was back to 9 per cent. in 2004. If the 1996 figure was 13 per cent., up from 10 per cent. in 1992, the fact that it was down to 9 per cent. in 2004 does not necessarily indicate an established downward trend.
On the Minister’s point about the effectiveness of smoking cessation services, it would certainly help the Committee if we could see the emerging results of the examination by the National Institute for Health and Clinical Excellence of those services. I think that NICE is due to give guidance on that in the new year; it should have completed work on its initial guidance for consultation this month. Will the Minister ask NICE to give us access to its emerging conclusions before we conclude our proceedings?

Caroline Flint: I will not give a firm commitment on that at this stage. I will seek advice on where NICE is regarding that information. I can provide figures that are already in the public domain on the number of people who have quit four weeks into the available programmes. I shall write to hon. Members of the Committee on that issue.
On the point made by the hon. Member for Northavon, I understand that before 1996 the reduction had hit a plateau. We have tried to influence that by education and by national and local campaigns—both are important—by providing additional services through the NHS and, of course, by tobacco control. I know that measures on the sale of tobacco to young people are important for my hon. Friend the Member for Barnsley, East and Mexborough (Jeff Ennis).
Where we are today is based on where we felt that a step change was necessary. The “Choosing Health” White Paper is recognised as having been substantial. Not just smoking but the whole area of public health came under scrutiny in order to identify what more we could all achieve by focusing on preventing rather than treating illness. I shall not go into the consequences of smoking. The hon. Member for South Cambridgeshire acknowledged, and we can all agree, that smoking is a killer. It is a major contributor to cancer, chronic heart  disease and other illnesses and we know that passive smoking can also kill—the hon. Member for Westbury mentioned a report in that regard.
For a long time, all political parties have publicly acknowledged the dangers of smoking. That is one of our reasons for supporting the messages on cigarette packets that advise people about the dangers. In that context, the question that was asked in the “Choosing Health” White Paper was, “How can we take the issue forward?” A great deal of progress has been made by organisations that have encouraged voluntary bans. Going by the ages of Committee members, many of us will remember when it was permissible to smoke on buses and tube trains, and even at the cinema and in theatres. That was part of the atmosphere in which we were brought up, but things have changed substantially over many years.
I acknowledge the point made by the hon. Member for South Cambridgeshire. By saying that we will achieve 99 per cent. coverage under these proposals, I do not for a minute take away from the fact that a number of workplaces are already smoke-free or provide smoking areas. However, our figures are based on 51 per cent. coverage, and the proposals will take us a long way towards our goal. That is not to diminish the actions that have already been taken—and continue to be taken—in workplaces and other public places. I was pleased to present certificates to some organisations in Doncaster, both public and private, that had decided to become smoke-free.

Andrew Lansley: The 51 per cent. to which the Minister refers is the proportion of workplaces in which no smoking is permitted. That figure is likely to be for 2002-03. What evidence has there been since then on the number of workplaces that are entirely smoke-free?

Caroline Flint: It is based on the 51 per cent. of people who report their workplaces as being completely smoke-free. It does not account for places in which there is a smoking room.

Andrew Lansley: That is for 2003.

Caroline Flint: That is the figure on which we base our information. I shall see whether there is any more up-to-date evidence. I do not want to get into an argument; I am being open and acknowledging that progress has been made on a voluntary basis. When we published “Choosing Health”, and asked the public and organisations what they felt about smoking, they expressed the view that we should go further, and that the time was right to legislate.

Andrew Lansley: Will the Minister give way?

Caroline Flint: No. If I could make some progress—

Andrew Lansley: This is a debate.

Caroline Flint: Well, the hon. Gentleman raised a number of points about the bases for our decisions. I will try to explain them even more thoroughly than we did on Second Reading. I will be happy to take interventions, if I can just finish my point.
When we asked people for their opinions in “Choosing Health” there was an overwhelming response from both smokers and non-smokers on the places where there should be restrictions. Some of that is also backed up by the smoking-related behaviour and attitudes survey that was conducted by the Office for National Statistics in 2004, which found that 88 per cent. of people supported restrictions on smoking at work, 91 per cent. supported them in restaurants, 93 per cent. in indoor sport and leisure centres, and 65 per cent. in pubs.
However, when people were asked whether they supported a complete ban, in relation to pubs the issue became much clearer. They said that where food was served in restaurants or pubs, there should be a complete ban on smoking, but only 31 per cent. supported a ban in establishments where there was just drinking. However, I should say that that was an increase of 11 per cent. on the previous poll. That shows that although there is not a majority in favour of a total ban, the public’s attitude is moving. What we are trying to do in this legislation is reflect public opinion, building on the compliance that there has been with voluntary bans because they have been in tune with what the public feel.
The Bill introduces a total ban, but with some exemptions. As my right hon. Friend the Secretary of State has said, there will be a review within three years and monitoring and evaluation from day one. That is the reason for introducing regulations; instead of having to come back with primary legislation, we can come back and change the regulations at a later date. This is based on good evidence.

Andrew Lansley: I am grateful to the Minister for giving way, as it is tedious for her to take interventions that refer back to points made long ago.
The Minister says that this is based on good evidence. Does she not agree that it is in fact based on an association in the public mind between smoking and drinking, as distinct from between eating meals and smoking, which they are opposed to, principally on grounds of the nuisance and irritation caused by people smoking around others who are eating? I want the Minister to focus on this point. She refers to evidence, but where is there any health justification for distinguishing between places where food is served and places where it is not? Surely the health evidence is distinct and very different from the nuisance reasons?

Caroline Flint: I intended to come to that issue. A combination of factors led us to arrive at our proposals, which we put in our manifesto. One factor, which I am sure that the hon. Gentleman is keen to acknowledge, is what we know about dangers to health from smoking. However, smoking is not an illegal activity so, if we are to legislate, how do we get the balance right? How will our proposals be applied? How will they be enforced? Are they in tune with public opinion? Are they a driver for change? Our policy reflects the different levels of evidence in respect of all aspects of the matter.
As for the question of smoking in food and non-food establishments, I do not believe that I or my right hon. Friend the Secretary of State or her predecessor have ever said that there was a health-related distinction. We have said that we have health evidence, but we also have evidence about what the public feel is right in respect of reducing exposure to second-hand smoke. People were very clear about where they felt there should be a total ban, and where they felt there should not be a ban. The hon. Gentleman raised this issue on Second Reading. This is a health Bill and it will reduce smoking in public places and workplaces. However, the fact of the matter is that it is also a balanced Bill that reflects where public opinion is at present. Arguments have never been put forward about a health divide in respect of food. What is clear, as the hon. Gentleman stated, is that people have a preference, and that is reflected in the Bill.
The Bill takes us on a journey. For the first time, we are legislating and not leaving it smoking bans to voluntary effort. We are legislating in a real and substantial way on the huge number of areas where not smoking is voluntary, and on a number of places where smoking happens. The Bill will make that an event of the past.

Andrew Murrison: Will the Minister give way?

Caroline Flint: I want to make a little progress in dealing with the points raised by hon. Members.
Some points were made about the regulatory impact assessment. Again, we have been very upfront. The RIA is primarily about costs, and it is obvious that a total ban would be cheaper. I said so to the Select Committee, and it has been said on the Floor of the House. We have to balance the options and how they fit in with our work on policy development, and we have to balance that against the costs. As a result, we have gone for a measure that takes us a significant step forward, but it allows a few exemptions.
This morning, we have talked primarily about bars, but let us not forget the other exemptions. Some are in line with those in Ireland and Scotland for establishments such as hospices, prisons and so forth; and even some hotels have designated rooms for smokers. We recognise that a total ban would not be appropriate.
In the Bill, we have something that is clear. It is a lot clearer than the policy of the Conservative party. I am bemused; I wonder what Opposition Members would do if they were sitting on this side of the Room, although I hope that that will not be for a long time yet. They seem to want to have their cake and eat it. I am happy to take an intervention before going on to the specifics of clause 1.

Andrew Murrison: The Minister is gracious in giving way. I am trying to find some sort of evidence base for what she wants to achieve. We have heard about the distinction between food and non-food areas, and the lack of evidence about the health benefits. She might like to comment on the 1 m-from-the-bar rule on which she seems so keen. It seems to have been plucked out of the air, and there is no real evidence for the health benefit; rather, it is a nuisance. I hope that the  Minister can understand our concern about the distinction between nuisance and health—this is a health Bill.

Caroline Flint: It is a health Bill, and I believe strongly that the measures in the Bill, particularly those in part 1 on smoke-free places, will contribute to a number of people giving up smoking and, I hope, stopping. Just as important, it signals a shift in the culture of the society in which we live; it will be predominantly smoke-free rather than allowing smoking with some smoke-free areas.
As I said before, we feel that there will be significant health benefits. However, it is also about public understanding and an acceptance of how people want to live their lives, which is why we are providing choice. I see no incompatibility between looking at health evidence on the dangers of smoking and then, through legislation, seeking to prevent smoking in a number of public places and workplaces.
The hon. Member for Westbury raised the question of the 1 m rule. I note from one of their amendments that the Conservatives would like voluntary bans to continue without any interference from the Government. The 1 m rule has resulted from a voluntary ban that is often used by the pub and leisure sector. We asked a question about that in our consultation; it is probably the one example of something that is currently used in the pub and leisure sector.
There is a debate about which of a number of measures would be most helpful in meeting our manifesto commitment to protect bar workers from exposure to smoke. We are continuing to consult on that. One measure is the 1 m rule, but we are not stuck with that. It was put in the consultation as a chance to debate how it might work and what other measures were available. Obviously, we will keep the House informed as to the results of that consultation when we come back with regulations on that.
The hon. Member for South Cambridgeshire asked an important question. He asked what was the point of the consultation that we carried out over the summer—a question that was echoed by the hon. Member for Westbury. There was a point to the consultation. First, it was on the proposals in the “Choosing Health” White Paper and was based on our manifesto commitment. There were 16 or 17 specific questions about enforcement, fine levels, the definition of food and non-food establishments, the bar area, timetabling and whether substances other than tobacco should be included. I will get to that final point eventually.
We got a huge amount back from that consultation. Yes, most responses were clearly in favour of a total ban. However, although people might want to go further, the measures that we suggest represent a step change: for the first time there will be a law that can be enforced to prevent smoking in certain places. There are aspects of the consultation on which we are not in agreement, such as the total ban. However, we have  taken on board issues that people have mentioned in relation to the timetable. We brought that forward by 18 months.
We have listened to people on clause 1 and the definition of smoke, and we are still listening to representations on some of the exemptions. We are in discussions with the Ministry of Defence and the Home Office about areas that they cover where there is a residential connection. We are talking to people in mental health about the issues that affect them. We have also taken soundings about fines, enforcement and signage. That will be reflected in our draft regulations. So it is not true to say that we have had a consultation and have not listened. Based on our principal position, we have listened to many points about how it will be implemented. We will discuss that further in Committee, but we still feel that our position, as set out in our manifesto, is right.

Andrew Lansley: Question 5, to which the Minister did not refer, invited views on the merits and practicability of the proposal for creating a distinction between pubs that serve food and those that do not. There were 41,833 responses. The Government summary states:
“The majority of responses to this question (over 90 per cent.) are against any exemption for pubs not serving food.”
In the face of such overwhelming opposition, why have the Government proceeded in precisely the same way as they originally proposed?
May I also ask a question about the evidence base for the “Choosing Health” White Paper proposal? The then Secretary of State for Health—the present Secretary of State for Defence—said that his reason for not having a total ban included the idea that that would lead more people to drink and smoke at home. We have previously discussed the fact that much of the scientific evidence about the negative effects of second-hand smoke relates to people who are exposed to it at home. Does the Minister think that that is a good reason for not having a total ban?

Caroline Flint: That is an interesting point. Regardless of the legislation, people in other countries, as well as in this one, have increasingly taken to drinking at home. Videos, CDs and DVDs have contributed to the increase in the number of people pursuing their leisure activities at home.
There is evidence from Europe, which I cited at the Health Committee, that people are increasingly buying alcohol to consume in their homes—hence the increase in beer sales. We need to address that, for the same reason as we need to address the problem of second-hand smoke in the home: we know that 95 per cent. of deaths from smoking are the result of smoking in the home.
Hon. Members expressed their concern to me before the summer that our proposals might push people into the home to smoke more. So far as I am aware, on the basis of a report that the Royal College of Physicians published in July, and another report that was published in Ireland, there is no evidence to that effect. I would be happy to write to the Committee to confirm that. I believe that I referred to those reports at the  Health Select Committee’s evidence inquiry. Those reports of the past six months seem to suggest that our proposals will not do that.
Our proposals recognise the fact that there is still a view that there should be choice about smoking and having a drink in certain social settings. That is what we are reflecting here, but we do not believe that removing that choice will lead to an exodus into the home. I hope that my earlier remarks put the matter into context. We are concerned about the amount of smoking at home, and our efforts to tackle that by giving people access to smoking cessation services, and by increasing awareness through campaigning, are designed to ensure that we do not lose sight of the health dangers to individuals, particularly children, of smoking in the home.

Andrew Murrison: Perhaps I am beginning to see the light. We are concerned about smoking at home, particularly as that means smoking in front of children. We are particularly concerned about things such as sudden infant death syndrome, which we know are causally related to tobacco smoke. If I understand the Minister correctly, she is saying that the reason for having a distinction between food and non-food is that that will preserve some sort of smoking den to which people can go, so that they do not go home with their six pack and smoke in front of their children. Is that a fair interpretation?

Caroline Flint: No, that does not at all reflect what I have just said. Again, this discussion is very interesting, because it makes me want to ask Opposition Members whether they support a full ban. On the one hand, they tease us with indications that the evidence leads to such a ban, but they do not actually step up to the plate and argue for one. They do not, in fact, step up to the plate and argue for any legislation whatever.
I believe that I was clear when I said that we were concerned about smoking in the home. That is why the Department of Health does a lot of work, and why a lot of work is done at local level by PCTs, Sure Start units and schools to address smoking in the home. Our proposals are clear about the distinction between public houses that serve food and public houses that do not serve food, and are not dependent on the idea that not offering the option of smoking in a public house that did not serve food would necessarily lead to an exodus of people to the home. I cited two reports from the past six months that have given us the latest evidence that there would be no such exodus.
I have tried to be very frank about the distinction between food and non-food, which we believed that the public were ready to accept in legislation.

Andrew Murrison: What about the consultation?

Caroline Flint: I am coming to that. The consultation in the summer was, as I said, one part of our deliberations. I respect the sincerely held views of people who took part in the consultation, but it involved many organisations and individual groups  that were very clear about their expectation or desire for a total ban. The number of responses was based on their campaigning for such a ban. We acknowledge their views, but we must set them against the attitudinal surveys of members of the public. There is an imbalance between the views of those who responded to that consultation, and the views of the public sought through other means. Governments take those views as soundings on where they feel public policy should move. The Government lead, but still reflect public opinion. Smoking is not an illegal activity, and we must take the public with us. Our view is that the legislation, which represents a total ban with exemptions, sets us on a journey to seek to win further public support in the future. The Bill is one way in which we can take the public with us.

Andrew Lansley: I shall not bore the Committee by quoting myself, but the Minister keeps talking about the Opposition not having wanted to put any provisions into legislation. I refer her to the Official Report of 29 November 2005, column 161, which records my words clearly setting out what we proposed. We shall return to the concept of a self-regulatory solution, backed up by legislation, in subsequent debates. We made it perfectly clear before the election that we were contemplating legislation.
The Minister has not disputed the fact that the regulatory impact assessment suggests that Government policy would have half the benefits of a comprehensive ban in terms of reduced mortality from exposure to second-hand smoke. However, the Government do not illustrate how that reduced mortality will be distributed, and the exacerbation of health inequalities that would result. If I understand the chief medical officer’s argument against the Government proposals, it is essentially that not only do they not deliver the maximum health benefits, but, in so far as the benefits are substantially less than they might otherwise be, the loss of benefit is disproportionately concentrated in poorer and more deprived areas where the mortality and morbidity rates are highest. How does that weigh with the Minister? She has not mentioned the objective of reducing health inequality; we know that that is getting worse, if anything. Where does that figure in her thinking?

Caroline Flint: Of course that is an important matter. I have learned over the last six months that we must look closer and in more detail at why more affluent, better off and better educated people are more likely to follow health information. We must grapple with that fact in order to close the gap. There has been some significant good work in some of our poorest communities on smoking, including the availability for pregnant mums to access services to help them give up smoking, and work through Sure Start. However, there is much more to be done; there is no doubt about that.
The overall rate of smoking prevalence for manual workers has come down to about 31 per cent., compared to 27 per cent. for non-manual workers. That shows a significant shift, but there is, of course,  more to be done. We recognise that tackling health inequalities is not done through one policy, but through a series of policies.
To tackle health inequality we must tackle poverty, access to employment, access to quality housing, and access to an environment in which people have aspirations for themselves and their families. That is at the heart of addressing health inequalities, and that is why I am in the Labour party. Alongside that is the recognition that there is no one-size-fits-all policy. We must bear down on what is preventing people from coming forward.
“Your health, your care, your say” asks, particularly in those poorer communities, why health services are not accessed in the same way as in more affluent areas. Are they fit for purpose and reaching need? Examining some of our spearhead primary care trust areas, it is quite interesting to see the impact that, for example, Sheffield has had in certain areas of health inequality compared with others. We can all learn from that. It is important to have a package of measures.
Dr. Murrisonrose—

Caroline Flint: Before I take another intervention, I wish to say how pleased I am that the number of homes in which smoking is banned in increasing. It has risen from a reported 45 per cent. in June 2003 to 58 per cent. in June 2005. That is to be welcomed. It underpins the strong message in choosing our health. Ultimately, it is about people choosing health for themselves, as much as it depends on legislation or intervention by the Government or others.

Andrew Murrison: I am pleased that the hon. Lady joined the Labour party to reduce inequalities—but by that measure, clearly her membership has failed, because health inequalities are becoming worse. Does she understand that making the distinction between pubs that serve food and those that do not will heighten health inequalities in both relative and absolute terms? Smoking dens will be created, especially in least well-off areas. Surely she understands that.

Caroline Flint: Tackling health inequalities involves a range of measures. That is why, under the Bill, more places where people from deprived communities both live and work will be covered than ever before. Statistics show that there are more workplaces that are currently smoke-free in middle-class professional areas than in manual working areas.
I take the point about pubs that do not serve food. We have said that we shall monitor and review the situation. People, especially workers in manual professions, a huge swathe of bar workers whom I would incorporate into the group that we are discussing, and those who work elsewhere in the hospitality industry, will be protected for the first time. They will be able to work in an environment without smoke, or be protected at the bar as they have never been protected before. That is a step forward in dealing  with health inequalities. We are clear about what we are saying here. On Second Reading the hon. Member for South Cambridgeshire tried to claim that his proposals were the same as ours.

Andrew Lansley: No I did not.

Caroline Flint: They are close to ours—I am just looking at the Hansard report of those proceedings. The hon. Gentleman referred to self-regulation followed possibly by legislation. He was not clear about how for how long he would continue to allow self-regulation.

Andrew Lansley: Yes I was.

Caroline Flint: I shall give way to the hon. Gentleman if he will make matters clear.

Andrew Lansley: On Second Reading I said:
“As we made clear before the election, we would have included provisions in a public health Bill to enforce a reduction in smoking in circumstances in which a self-regulatory solution had not been effective in three years.”—[Official Report, 29 November 2005; Vol. 440, c. 161.]

Caroline Flint: That underpins an amendment that the hon. Gentleman has tabled. It suggests that if there were a Conservative Government, we would have a system under which with voluntary bans would be allowed to continue. When we discuss that amendment I shall explain why we shall not accept it. It would not help to move the agenda forward. It would raise more questions about how to determine whether someone had self-regulated to a proper extent to reduce smoking environments, as well as a lot of issues in connection with regulations—but we shall come to that when we deal with the amendment.
Now I want to say a little about clause 1 and our definition of smoking, which was picked up by the hon. Member for Northavon. The definition of smoking covers being in possession of tobacco, substances that include tobacco or other substances that are alight. That means that the Bill will cover non-tobacco cigarettes, such as herbal cigarettes, and that being in possession of any sort of lit substance—for example, smoking a hookah pipe—would be classified as smoking. We have included non-tobacco products following consultation responses, which pointed to published evidence of the harmful emissions from non-tobacco cigarettes. I think that that was provided by Action on Smoking and Health.
We also received consultation responses that recommended widening the definition to allow easier enforcement. With a narrow definition involving only tobacco, there is a risk that smokers will claim that their cigarette is herbal, which would result in dispute and practical enforcement problems for both the owner of the premises and the enforcement officers. That has been a problem in Ireland, which did not have such a definition to start with. We do not want enforcement officers to have to send cigarettes for testing, at a cost disproportionate to the offence, or altercations between members of the public, or premises owners and members of the public, over whether a cigarette is tobacco or herbal based. I hope  that I have answered questions sufficiently. I will follow up in writing some of the points raised this morning.

Question put and agreed to.

Clause 1 ordered to stand part of the Bill.

Clause 2 - Smoke-free premises

Steve Webb: I beg to move amendment No. 40, in clause 2, page 2, line 17, at end insert—
‘provided that the part of the premises that is open to the public or (as the case may be) used as a place of work is segregated from the remaining premises to standards that the appropriate national authority may specify in regulations.’.

Eric Illsley: With this it will be convenient to discuss the following amendments: No. 46, in clause 3, page 2, line 40, at end insert—
‘provided that any area of a premises that is provided as not smoke-free at any time shall not share floor space unsegregated by a wall or door with any area that is smoke-free at the same time.’.
No. 48, in clause 3, page 3, line 5, at end insert—
‘(c)requirements for segregation of smoking and non-smoking areas, provision and maintenance of ventilation systems, and restrictions on deployment of staff in smoking areas.’.

Steve Webb: This group of amendments touches on the issue of separation and segregation. As I said in my opening remarks, now that there is not to be a total ban, there will be parts of premises and categories of buildings where some smoking is allowed, which might be adjacent to areas in which smoking is not allowed. Therefore, we must consider how the distinction between smoking and non-smoking areas should be drawn, how to ensure that smoke in smoking areas is not detrimental to non-smoking areas, and how they should be separated.
Amendment No. 40 would amend clause 2(3), which concerns premises that are described in the explanatory notes as
“someone’s home as well as their workplace”,
such as someone’s home in which music lessons are given or from which financial services are offered.
Subsection (3) seems to say that areas into which the public may come or in which they are served will be smoke-free, but that other parts of the premises do not have to be smoke-free. Suppose that music lessons are given—or some other service is provided—in the front room of a house; that does not mean that the person who owns the house or provides the service from home cannot smoke in the kitchen. Amendment No. 40 is about the distinction between two parts of the same premises. Is it sufficient to say, “We provide music lessons in the front of the house, so there is no reason why we shouldn’t smoke in the back of the house,” considering that if the smoke travels it will be detrimental to people using the public place, which is a workplace, at the front of the house? What are the dividing lines? How are such places to be cordoned off?
On the theme of music lessons, I play the oboe in my spare time. My oboe teacher was a pipe smoker, and the small practice rooms in our school were constantly full of pipe smoke, although the teacher never smoked while I was in there. That probably was not an ideal environment in which to teach a pupil to play a wind instrument.
We are talking about a situation in which smoke from another part of the house or premises could waft in to where people are having a lesson or receiving a service. What segregation should there be? The amendment suggests that there should be some standard to determine that set down by the appropriate national authority. Clearly, circumstances will differ in private houses, but we want to avoid a situation in which the letter of the law is followed so that there is no smoking in the immediate place in which the service is provided, yet there is smoking elsewhere on the premises, which, because of the inadequate segregation, is detrimental to the public and anyone else who works in that environment.That is the thinking behind the amendment. [Interruption.] Excuse me; that is not a smoker’s cough, I assure you, Mr. Illsley.
Amendments Nos. 46 and 48, which would amend clause 3, concern similar issues. Amendment No. 46 is also about segregation, but in relation to pubs and similar environments. The amendment provides that areas designated as smoke-free should be substantially separated by a wall, door, or similar. Relevant issues that we touched on briefly in our previous discussion include the 1m-from-the-bar rule.
The Secretary of State said on 26 October that
“smoking in the bar area will be prohibited everywhere ... We shall consult further on the best method to achieve this, including on discrete smoking rooms or areas to protect staff.”
The amendment shows that whatever may come out of the process, we do not think that an arbitrary distance with no physical separation achieves the goal. I accept the Minister’s point that custom and practice—good form, decent employers, people who do not want their bar staff to have someone puffing a cigarette straight in their face—might have come up with the standard of one metre, but I hope that the Minister will accept that there is no health basis for it. Smoke circulates; the second that somebody opens the door to come into the pub, smoke wafts around. It is hard to say that a separation by distance will achieve the public health and safety goal that should be the purpose of the legislation. If the Government insist that there should be areas where smoking is permitted—we remain of the view that there should not—they should be clearly separated by some physical barrier.
I shall now move to amendment No. 48. There will continue to be places where workers will be exposed to second-hand smoke; the non-food pub is a classic example of that—albeit not within a metre of the bar. To say that people who work there will be thrown to the wolves might sound slightly hysterical, and I would never want to do that, but essentially they will be abandoned beyond the existing health and safety legislation. Workers in private clubs will, essentially, have to lump it. The amendment says that that is not good enough. If the Government insist on some  workers still being subject to second-hand smoke, we should none the less beef up the health and safety protection that they get. We suggest that even for them, there should be restrictions on the
“deployment of staff in smoking areas.”
One possibility is that the Government will come up with a “smoking carriages” idea: in pubs that do not serve food, smoking will be permitted in sealed rooms. But who has to work in those sealed rooms? Will cleaning staff have to go in? Will bar staff have to take the drinks away? What happens if a fight breaks out? Who will have to go in then?
Amendment 48 asks for clear restrictions so that workers know what they do and do not have to do in terms of deployment to smoking areas. Essentially, they are being asked to go into an unhealthy environment. It is not good enough to say that that will be done by negotiation with the employer. In the past I have given the example of Sunday trading, when people may have a theoretical right not to be forced to do something, but when the individual employee, relative to their employer, can be in a vulnerable position. If the Government were to say that the remaining workers have no protection beyond the existing health and safety rules, that would be unsatisfactory.
So our third amendment would set out in clause 3 requirements for segregation and ventilation. As I understand it, the ventilation required to get rid of all the particulates would be something of a whirlwind, which is not credible. There should at least be some regulation so that if staff have to go in and clean, or take glasses away, they know where they stand. If this is a Health Bill about the health of workers, they need enforceable rights. They need to know where they stand, what they can be reasonably expected to do and how often. It is not a private matter or a free collective bargaining issue. It is about their health and safety, and we believe that the amendment would provide the opportunity to protect workers who have otherwise been neglected by the Bill.
I will now draw together the threads of the three amendments. Our focus is on concepts of separation and segregation in the imperfect world that the Government want to take us to. We want to deal with the fact that smoke drifts, and that a 1 m exclusion zone, or anything else of that kind, will not work. We want to give the workers who will, residually, still suffer from the Government’s timidity some rights to protect their health.

Andrew Murrison: There was a great deal of sense in the hon. Gentleman’s remarks. I am not usually kind to the Liberal Democrats—he has probably noted that—but on this occasion he has made a useful contribution and opened up an important debate. It is a debate on which the Minister has failed. We are considering a workplace. In general we are concerned, with respect to workplaces, about occupational exposure standards, airborne contaminants and the levels of those that are regarded as safe, and the Control of Substances Hazardous to Health Regulations. I know  that my right hon. Friend the Member for North-West Hampshire (Sir George Young) is keen on that issue and he will return to it in his amendments.
We are dealing with a workplace that appears to be poorly regulated in comparison with other workplaces, and it is appropriate for us to consider that and decide how we might improve the occupational health of the people who work there. I declare an interest in that before I was elected to this place I was a consultant occupational physician. As I read the Bill, I was staggered by the lack of consideration that the Minister has given to what would be regarded, in an occupational setting, as frankly minimal standards in the matter of what it is or is not reasonable to expose workers to.
We have heard nothing from the Minister about COSHH or about occupational exposure standards. The debate about segregation—physical segregation and segregation by time of exposure, distance and ventilation—seems not to have been considered by the Minister at all; or, if it has, that has been merely en passant. In particular I am concerned that the Minister has not adequately explored the question of ventilation and that perhaps it has not been considered among the possible exemptions of which she gives examples. She might consider ventilation for clubs, for example, that might be exempted under the regulations. Perhaps we might also have occupational exposure standards for tobacco smoke to protect workers in those places.
I am alarmed by the poverty of imagination and the Minister’s ability to ignore, in the Bill, normal occupational hygiene measures and language. It is almost as if the Minister is telling us that we are dealing with a workplace, but that it is not quite a workplace in the normally accepted way of thinking. If she went to any industrial complex she would find occupational hygienists measuring air flow, airborne contamination and the rest of it to the nth degree, yet there is no reference to those practices in the Bill.
I urge the Minister to think seriously about bars and clubs as workplaces rather than just giving us polemic about protecting workers’ rights. I urge her to consider how proper workplace standards might be applied to people who work in those pubs and clubs. If she did that, she would, I think, come up with a very different Bill, which would, for example, mention such things as the Health and Safety Executive, COSHH and occupational exposure standards. There is nothing in the Bill about them and no reference, even in the guidance notes, to any of them, although they are the weft and warp of normal occupational hygiene. She has ignored them and all that we have are illogicalities. No serious thought is given to how to separate workers from a potentially noxious substance. There is the 1 m from the bar rule, but we know—the Minister has admitted—that it has no basis in fact. There is no evidence base for it. It has been plucked out of the air.
There is a reference to smoking at the bar. I suppose that we can understand that someone who does not smoke and who is serving behind the bar might find that offensive so, anecdotally, there is a reason for specifying smoking at the bar in the Bill or the  guidance, but there is no evidence. No one has gone out and done any serious measurements relating to exposure to tobacco smoke which would inform the Bill; everything is anecdotal. We should not be legislating on the back of anecdote. We need to legislate on the basis of evidence, but there is a poverty of evidence in the Bill so I hope very much that the Minister will take a more serious look at the issue. Perhaps we could have rather less polemic and rather more evidence. If she provides that, we will end up with a Bill that is considerably better than the current one.

Caroline Flint: Clause 2(3) covers premises that are only partly public and workplaces, for example, where services that the public use are housed in someone’s private residence. The example of a music teacher was given. Another example might be a GP who has his surgery in his home, or a pub where the tenants live on the premises. In respect of those examples, subsection (3) provides that any area of the property to which the public have access will have to be smoke-free. As was outlined and as is clear in the Bill, smoking will still be allowed in private areas of the premises, as the Bill is concerned only with public places and workplaces.
I understand the intention behind the amendments tabled by the hon. Member for Northavon, but I am concerned about putting those measures in the Bill. One effect of amendment No. 40 would be to require public smoke-free areas of the premises to be segregated from the private areas of the premises if smoking was ever to take place in the private areas. I understand that the provision the hon. Gentleman is challenging us to move towards has not been felt to be absolutely necessary in Scotland or Ireland. Although I acknowledge his point, there are issues for people who use their private premises as a workplace regarding the responsibility on them for ensuring that the public have access only to smoke-free areas. The amendment would provide a power to make regulations specifying the requirements for that segregation. I do not believe that that is a matter on which we should legislate in the Bill. It is up to the individuals living in the private spaces to decide how they will fulfil their obligation under the Bill to ensure that the public areas of the premises are smoke-free.
There are so many different examples that we could give in relation to smoke-free places, whether partially or wholly, that we could find ourselves in a difficult situation, trying to cover all bases in the Bill. The provision in the Bill for regulations will give us a chance to produce draft regulations, discuss the issues and approve the regulations at a later date. I understand the hon. Gentleman’s concern and intention, but specific requirements for segregation, as outlined in the amendment, would be over- burdensome on this occasion.

Steve Webb: The Minister will notice that amendment No. 40 does precisely what she has said should be done: it would not put in the Bill provision for precisely how things would work, but would give the national authority the power to make regulations.  If we do not make regulations, presumably the issue will be decided by the courts and we will have a situation in which someone says, “I teach in the front end of my very big front room, which is smoke-free. I smoke occasionally at the far end of my front room, but that’s such a long way away that I am not breaching the rules.” Surely if we do not specify matters in regulations systematically, they will be decided ad hoc in the courts.

Caroline Flint: The intention is clear from what we are saying about places to which the public have access being smoke-free. It would be incredibly burdensome to go into greater detail on buildings that are part private and part public, a few examples of which have been cited. We might specify to someone, for example, whether they should have double doors, what sort of doors they should have and so on. There are balances to be struck. Obviously, hon. Members will raise issues in Committee and I shall reflect on them outside Committee, but I am not convinced at the present time. I understand that, in both Ireland and Scotland, the proposed measure was felt to be unnecessary; it was felt unnecessary to be more prescriptive.

Andrew Murrison: Does the Minister agree that if she treated places in which people might be exposed as workplaces, the dilemma to which she refers would be avoided? Surely that is the crux of the matter.

Caroline Flint: I will try to cover all the contributions that have been made, and if I do not I shall be happy for hon. Members to intervene. However, I shall be grateful if hon. Members will give me a chance to answer their points rather than constantly repeating them. The point made by the hon. Member for Westbury applies in different ways to all the amendments put forward by the hon. Member for Northavon. Rather than both of us repeating ourselves, I shall come to them in due course.
On amendment No. 46, clause 3(3) sets out in detail how we might regulate to provide for exemptions from the prohibition on smoking in closed public places and workplaces. They might apply to whole premises or to areas of premises, and the exemptions will apply only if specific conditions are met. We will set out those conditions in regulations. Amendment No. 46 is an attempt to specify in the Bill the sort of conditions that we have clearly said, both during the consultation process and when introducing the Bill, that we intend to put into regulations.
In many respects, particularly in relation to clause 3, we have put headline issues into the Bill to show intent—to help people to understand what the Bill is all about. The regulations will have to deal with the wide variety of ways in which the law might be interpreted. That is why regulation-making powers will be an important part of the next stage of the process. When drawing up and consulting on the regulations, we shall consider carefully the underlying point made by the hon. Member for Northavon in relation to amendment No. 46. As we have made clear previously and as he highlighted, smoking rooms may be one way of delivering in regulations the commitment that we have made to prohibit smoking  in the bar areas of exempted premises. However, I do not feel that we should deal with that in detail in the Bill. I hope that he will allow us to complete our consultation and propose draft regulations with a view to making it clear how the protection of bar areas should be enforced.
Clause 3(4) sets out examples of the sorts of conditions that may be considered when setting out the circumstances in which premises or areas of premises are not smoke-free. We have given the examples of restrictions on what is sold or consumed in such premises or areas of premises apart from alcohol, and the designation of smoking rooms. Amendment No. 48 would add to that list of conditions. In particular, it would add the segregation of smoking and non-smoking areas, ventilation requirements and restrictions on staff in smoking areas. Again, although I understand the intention of the amendment, I am not sure that it is helpful to put into the Bill all the possible considerations that will go towards forming the regulations on exemptions.
We will have an opportunity to discuss whether the listed criteria are exhaustive or too narrow. We believe that the way in which the clause is drafted makes the key considerations sufficiently clear. For example, there are further amendments concerning ventilation. There is a huge debate to be had on the contribution of ventilation, and on what it extracts from the air and what it leaves behind. If we were to go down that route, how prescriptive should we be about what sort of ventilation should be provided? So far, having heard the many views on the subject, we think that we have gone in the right direction.
The hon. Member for Westbury expressed disappointment that the Bill does not focus more on health and safety, and he referred to the Control of Substances Hazardous to Health Regulations, which apply to substances that are generated by some work activities. The Bill is neither employment legislation nor health and safety at work legislation. We have been clear about that, both in terms of the outcome of the “Choosing Health” White Paper and in our consultation over the summer. The Bill intends to reduce the number of places in which smoking can occur. Employees should have the same rights with their employers under employment and health and safety legislation as they currently have. That is proper and should be applied regardless of whether a workplace is smoke-free or allows limited smoking.
This morning, some of the focus has been on bar workers. There are other situations to debate—for example, when people go to give services in somebody’s home. I do not think anybody is saying that a pensioner who smoked would have to introduce ventilation or give up smoking before a service—either a home help or something else—that they needed was provided. There would have to be a way to handle such a situation.
As far as I am aware, many employers in the public sector, and some in the private sector—we could be talking about someone coming to read the gas meter—  would expect that smoking would not take place in front of the worker when they visited premises. That raises—

Andrew Lansley: Will the Minister give way?

Caroline Flint: I will just finish the point, which was about different workplaces and the complexities involved. Our main aim in this Bill is to legislate to improve access to choice about the places in which people can work and socialise in a smoke-free atmosphere.

Andrew Lansley: Clause 2(2) is about premises that are used as a place of work. The Minister will correct me if I am wrong, but there is a difference between places that are open to the public, which are smoke-free to that extent and for that period of time, and premises used as a place of work, which are smoke-free to that extent but all the time. The provision includes the phrase:
“They are smoke-free all the time.”
I am not quite sure what that means. Does it mean all the time that they are a place of work or all the time for ever? Where is the boundary? If a plumber and his mate come to work in my bathroom, it is a place of work for them and more than one person is involved. I hope that my bathroom would always be smoke-free, but that is not the point. Does that turn my home into a place that must be smoke-free all the time that they are there or smoke-free for ever?

Caroline Flint: To draw a distinction, we are dealing with situations involving a public place or a workplace. I made a point about where services come into someone’s home. We are not defining the person’s home as a workplace. The hon. Member for Westbury raised points about employees and access to smoke-free environments. We are legislating in relation to workplaces. As I understand it, where part of a premises is a workplace, that should be smoke-free—I will clarify this, if necessary—and a workplace should be smoke-free at all times. The provision does not include situations where people invite a plumber in to do some work in their home.
Appropriately, this is a public health Bill that reflects public opinion as well as health evidence. It is not primarily a narrow worker-protection matter. We are aiming to increase substantially the number of smoke-free public places and workplaces. As I said, I am not sure whether using ventilation or air-quality standards for workers would contribute to that. Therefore, on this occasion, I cannot agree to the amendments tabled by the hon. Member for Northavon. However, I listened to what he said and some of his points will form part of our decisions and deliberations in bringing forward the draft regulations.

Steve Webb: I am grateful for the Minister’s sympathetic tone and for the fact that she recognises some of the issues raised in the amendments. Our discussions this morning have already helped me in one important respect: I have noticed something that I failed to notice on Second Reading, which is that the  Bill that provides for smoke-free public places does not at any point define “smoke-free”. That is a pretty central problem because, to develop the point made by the hon. Member for South Cambridgeshire, if a home is used as a workplace and we agree that the bit that is used to serve the public has to be smoke-free—

Jane Kennedy: That means no smoke.

Steve Webb: But does that mean no smoke ever? Does it mean that, as soon as somebody has smoked there once, one assesses the residual particulates and says, “There is still some damage to be done, so it is not smoke-free”? If it is adjoining and not segregated from somewhere else in the house where there is a chain smoker puffing away like billy-oh and someone opens the door and it all wafts in, is that still smoke-free? If the Government and the regulations do not decide what the definitions are, the courts will and that is always the second best solution. If we in this House have a view about those matters, we should be defining them now, rather than leaving them, literally, as a grey area for someone else to intervene on.

David Kidney: To assist the hon. Gentleman, I should point out that we spent rather a long time on clause 1, which deals with what “smoke-free” means. Clause 1(2) specifies that it has to have something to do with smoking about it.

Steve Webb: Yes, but it does not say when. It says “smoke-free” means that one cannot be
“in possession of lit tobacco”.
However, let us think about the ban on pubs that serve food: if they serve food at lunchtime but not in the evening, one still cannot smoke there. The point, presumably, is that smoking in the evening will affect the smoke-free status at lunchtime. There is a temporal aspect to this: it is not just that one cannot do it at the time, but that there is a knock-on effect for the future from smoking at some point of time. It is not intended to be a nit-picking point, but a fundamental one. If we think that passive smoking is deleterious to people’s health, it does not have to be passive smoking in somebody’s face; it could be at a distance or at a different time in the same place. At present, it is unclear what is prohibited and what is not. That is why we want some things on the face of the Bill, as the amendments suggest.
The Minister said on amendment No. 46 that some of the issues that we have raised will be brought up in regulations, and that is welcome, but what we are trying to do is to rule things out from the start. One of the things that we want to rule out from the start is the idea of distance as an adequate protection against second-hand smoke. Beyond extreme examples, if we are talking about credible premises and say that a few more metres is enough, given the circulation of air and smoke, a distance-based criterion for exclusion is a non-runner. That is what we were trying to do with amendment No. 46.
On amendment No. 48, the Minister said that clause 3 has examples of the main themes for the Government. However, the rights of workers are fundamental, as the Bill is about protecting the worker’s health. The Government can say that they have included the big things, such as food and private clubs, but that they will deal with workers’ health in regulations. The Minister essentially said—she will correct me if I am wrong—that workers who continue to face smoking environments because of the Government’s exemptions will have no additional protection beyond existing health and safety legislation.
Caroline Flintindicated dissent.

Steve Webb: Let me re-phrase that. The Minister seemed to imply that that was in some sense sufficient for those workers and that they would get no more protection than that. If we have decided that other workers need more protection because we are doing their health harm, I cannot see how it is sufficient not to put in the Bill something that guarantees those workers’ safety. In many ways, the workers who are still going to be exposed to second-hand smoke after the Bill is enacted are in the worst position of all. We ought to worry about those people and not just say, “We’re helping some people, so blow the rest.” There should be something quite explicit, up front in the Bill to guarantee the rights of the workers who are still going to be exposed. That is our concern.

Andrew Murrison: Does the hon. Gentleman accept that insisting on occupational exposure standards would do just that and put people who work in bars on the same footing as somebody who works in any other workplace?

Steve Webb: Indeed; it is all to the good, to the extent that there are existing standards off the shelf that will do the job, so what we are requesting becomes all the more reasonable—and we on these Benches are always reasonable.

Andrew Lansley: Before we conclude this debate, I have to say that I am worried, as is often the case, that we are starting to expose things but that we will move on and find it difficult even to refer back.
Does the hon. Gentleman agree that we have not established the position in relation to people’s homes that are treated as places of work for a period? What happens then? It is fairly straightforward that if those places are open to the public, they are smoke-free to the extent that they are open to the public, either geographically or in time. Where they are places of work, it is clear that they are smoke-free to the extent that they are places of work geographically, and the hon. Gentleman’s amendments are designed to try to clarify that to a greater extent. However, that has rather exposed the sentence:
“They are smoke-free all the time.”
The hon. Gentleman and I do not understand what “all the time” means. Does it mean all the time that people are in a place of work, or all the time beyond that point—through the night, the weekend, the rest of the year or the rest of eternity? When does it stop?

Steve Webb: The hon. Gentleman highlights an ambiguity. I presume that it is not just the time when a premises is in use.
If hon. Members can imagine going into a waiting room in a doctor’s home and nobody was smoking there at the time but a chain-smoker had been there all through the night, they might feel that the spirit of the Bill had not been fulfilled. I presume that the provision works over time, as well.
On the hon. Gentleman’s issue of the plumber in his bathroom—whom I am sure we will get to know better as the weeks go by—

Andrew Lansley: And his mate.

Steve Webb: Indeed.
My understanding is the other way round. None of that falls within the scope of the Bill. It is the hon. Gentleman’s house, not a premises that is open to the public. If I am getting it wrong, I am sure that the Minister will come back to us.

Caroline Flint: I will try to be helpful.
The exemptions proposed in clause 3(2)(a) specify the sort of places where smoking can continue. The exemptions include
“premises where a person has his home”,
so it will depend partly on, for example, whether a separate room in the home is used only for music lessons or as a doctor’s surgery. If that were so, it would be smoke-free. Hon. Members are moving towards dealing with a family room where lessons occasionally take place. In those situations, we would not expect a total ban to apply. However, that is an important point and we will look at when we draft regulations.
This is about a proportionate response. It raises the issue of all the different ways in which someone can have a home and a workplace. In some cases—for example, a general practitioner’s surgery—it will be obvious what the workplace is and what it is used for. People do not have their Sunday lunch in the surgery. However, that is different from a music teacher offering piano lessons or, in the hon. Gentleman’s case, oboe lessons, in their front room.
I will reflect on the issue. I think that there is a point, but it is about being proportionate, which is something that we should cover in regulations.

Steve Webb: I am grateful for that.
This group of amendments has raised some valuable issues and has, therefore, contributed healthily to our deliberations. I shall not divide the Committee, so I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Steve Webb: I beg to move amendment No. 41, in clause 2, page 2, line 21, at end insert
‘provided that any area of premises which is more than one half enclosed shall not be defined other than as enclosed or substantially enclosed.’.

Eric Illsley: With this it will be convenient to discuss the following amendments:
No. 69, in clause 2, page 2, line 21, at end insert
‘having regard to the excess health risk conferred on an individual by virtue of the enclosure.’.
No. 45, in clause 3, page 2, line 37, at end insert
‘provided that no employee of such a club or of any business or organisation providing goods or services to that club shall enter any area of the club that is enclosed or substantially enclosed at any time that such premises are specified not to be smoke-free.’.

Steve Webb: I feel that the Committee has not benefited enough from my voice this morning.
Two different sets of issues are raised by amendments Nos. 41 and 45, tabled by my hon. Friend the Member for Bristol, West and me, and by amendment No. 69, tabled by the Conservatives. With amendment No. 41 we are moving on to enclosed and substantially enclosed public places. Clearly that is an important definitional issue. I hope that when the Minister responds to this group of amendments we will get much clearer idea of the Government’s thinking on how this will be implemented.
We have to get our heads around what the percentage threshold used to define “substantially enclosed” should be. Those of us who want a comprehensive ban want it to be at the lower end of the scale, and those who want a fairly limited ban want it to be at the higher end of the scale. If we say that something is substantially enclosed only if it is 70 per cent. enclosed, many fairly enclosed public places would still allow smoking. If the threshold is 50 per cent., more places would be brought in.
My broad understanding is that in the Irish case the threshold is half. If half of an area is enclosed, it qualifies as substantially enclosed and therefore falls within the scope of the legislation. Indications from the Government are that they would be looking more towards a 70 per cent. threshold. I am a little bit hazy as to how one defines percentages in this context. Are we talking about the floor area or the volume? That is far from straightforward, so this is a probing amendment to try to ascertain the Government’s thinking.
Essentially, we want to avoid loopholes. One could imagine a veranda area of a pub which, if the threshold was set fairly high and two panes of glass were removed, would fall outside the scope of the ban and people could still smoke there. Whatever threshold is chosen, there will be arbitrary lines of that sort. Clearly, we would want the spirit of the legislation to be observed, which must mean public areas that have a significant character of being enclosed. That for me has the feel of more than half rather than more than two thirds. This is obviously subjective.
We have talked a little about the evidence base. The whole debate is about something that is relatively new. Comprehensive bans do not go back much further than the late ’90s, certainly in places such as California. But there have been partial bans going back a lot further than that. What evidence will the Government use to determine the sorts of threshold that they want to use to define “substantially enclosed”? Clearly there will be a lot of concern in the pub and entertainment industry. They will want clarity. Whatever figure we choose, they will want something that is clearly defined. I hope that the Minister will give us some answers that will tell the people who will have to make preparations to implement the Bill what they have to do. That is the nub of amendment No. 41.
Amendment No. 45 relates to a different set of issues and to people who work in private clubs. We are concerned about the workers—I am sounding like a real old leftie—and the requirement for them to enter enclosed or substantially enclosed places when those premises are not smoke-free. All these debates interact with each other. In a private club with a semi-enclosed area, will the bar staff, cleaners or whoever have to go in there while people are smoking? Obviously we would prefer workers in private clubs to be completely protected, but if they are not to be protected, should they not at the very least be protected from “in your face” second-hand smoke?
We hold to the view that there is a much bigger longer-term danger of general exposure. But clearly, going in while people are smoking is key. I guess that the link with the idea of semi-enclosed public places is that if there is a draught, some openness or some ventilation, over time the impact of second-hand smoke might be diminished by the fact that the place would not be 100 per cent. enclosed. We want to protect workers when they would be most exposed, which is when people are actually smoking. I accept that these are two slightly different sets of issues.
To sum up, we are trying to get a clear definition of “substantially enclosed”, which we would like to be much more comprehensive than the Government envisage, and we are trying to ensure that workers in private clubs who are going to be exposed to second-hand smoke are not exposed to it at the point at which it will do the most damage.

Andrew Murrison: This is an interesting group of amendments. It is particularly interesting that amendment No. 45 is grouped with amendments Nos. 69 and 41, because it introduces a new range of issues relating to private membership clubs.
However, I would like to direct my remarks chiefly to amendment No. 69, tabled in my name and those of my party colleagues. Its purpose is to underscore the need to insist on an evidence base for the provisions of a Health Bill. The guiding star for my hon. Friends and me has been this question: how will the Bill improve people’s health? We are not as interested in nuisance,  amenity or courtesy, because although those matters are important, this is a Health Bill, and we believe that they should be dealt with in other legislation.
What we want to focus on above all is the impact on health of both second-hand smoke and smoking in general. Amendment No. 69 insists that when we define what is enclosed and what is not, we ask how it will affect public health, based on the evidence available to us.
We are intrigued by amendment No. 41, and we agree that there is considerable ambiguity; indeed, ambiguity runs through the Bill. A lot is left to the imagination, but that has to do with the Bill’s structure and the fact that much will be contained in regulations, the contents of which we are not certain about.
We need more clarification of what is in the Minister’s mind when she talks about “enclosed” and “substantially enclosed”. We share the dismay of the hon. Member for Northavon that the Bill does not contain something a little more specific that gives us some clue what is in the Minister’s mind. In the guidance notes and elsewhere, she has referred to examples of stadiums to which regulations may apply. That touches again on the distinction between public health issues and amenity or nuisance issues. I underscore the fact that we believe that such matters should be determined by considerations of improving public health, rather than of nuisance or amenity.
It is difficult for us to see how smoking in a stadium would have a significant impact on an individual who happened to be there for a while. It clearly would not, except under very specific circumstances; my hon. Friend the Member for South Cambridgeshire referred to one or two of them. We also need to consider what a bus shelter is. It is substantially enclosed, but it is not clear whether people waiting for a bus in the rain would be prevented from smoking in a bus shelter.
If I am not careful I will trespass on the ground of the former Secretary of State for Health, who is now the Secretary of State for Defence, and his interpretation of the legislation and where the Government should be going. Far be it from me to encourage divisions between Ministers, but his philosophy on this issue is profoundly different from that of the present Secretary of State for Health.
I would like some clarification about what is enclosed, what is not enclosed and what is substantially enclosed. I accept the Minister’s argument that it would be inappropriate to put down chapter and verse to the nth degree; that would be impossible. However, the Bill leaves far too many questions unanswered. I entirely share the concern expressed by the hon. Member for Northavon that it will be a bean feast for lawyers. I look around the room, Mr. Illsley, and I see no lawyers, so I can be as mean as I like about them. They will be eyeing up the Bill with anticipation, and we must do what we can to deprive them of whatever livelihood they might derive from it.
Amendment No. 45 touches on a new range of concerns to do with private membership clubs. We would draw a distinction between public and private  space. To some extent, I accept the Minister’s concern that the Bill is a compromise between the desire to improve public health and the desire to maintain individuals’ right to do as they wish. However, those two meet on the question of private membership clubs, which are dealt with in clause 3. Such clubs are not public spaces but, I submit, an extension of private space. None the less, we must consider work-related matters. People work there, and my comments on occupational exposure standards, the Control of Substances Hazardous to Health Regulations 2002, the Health and Safety Executive and the rest still pertain to private membership clubs. Nevertheless, they are distinctly different from pubs that serve food—and, indeed, those that do not. In that context, it is right that they should be considered slightly separately.
We also have to consider what is trivial exposure. That is where I probably disagree with the hon. Member for Northavon, although the amendment is well made. The Minister cited the example of someone being called into a smoking room—perhaps because of an altercation—who had not been habitually exposed to such an environment. Unless that person had an unusual medical complaint, that could be regarded as a relatively trivial exposure, but I am not sure whether the Minister intends such trivial exposure to be covered by the Bill.
Similarly, the amendment would remove the possibility of those working in private membership clubs being exposed to tobacco smoke. That is a purist way of looking at things, and I am not sure that it has any grounding in evidence. I accept that it is unpleasant to go into a room full of smokers—it is not something that I would want to do—but workers should have an element of choice. Those who work in private membership clubs, or in the hospitality sector in general, are less likely to have an aversion to tobacco smoke, but that does not mean, as has been said before, that we should not give them protection from second-hand smoke. However, when we are considering relatively trivial exposure to second-hand smoke, it is practically and realistically germane to the argument.
A conflict arises between the need to protect public health and protecting the occupational health of employees. The question is where to draw the line. Insisting that nobody, under any circumstances, should come within a million miles of a whiff of tobacco smoke is unrealistic. I am not entirely convinced of the logic of the hon. Gentleman’s amendment. However, measures can be taken, such as insisting on proper ventilation, even in private membership clubs. That would get round some of the concerns that he rightly expressed.
If we can put in place measures that would reduce occupational exposure to smoke to an acceptable level, even in private membership clubs, which I maintain should be exempt, that would be a positive thing. However, I see nothing in the Bill that would enable that to happen, or make it more likely. I insist that proper occupational exposure standards for people who work in environments where there will be  exposure to second-hand smoke would be a positive way forward. It would improve the occupational health of people in the hospitality industry overall, and in the context of the amendment, it would improve the occupational health of people who work in private membership clubs.
I suspect that that suggestion might make me terribly unpopular with a range of private membership clubs, such as working men’s clubs and even Conservative clubs, so I must be a little careful about how far I take it. However, most people would accept that reducing employees’ occupational exposure is a good thing. I am concerned that nothing in the Bill makes reference to the part that ventilation and engineering can play in reducing occupational exposure in the categories that the Minister is minded to exempt by regulation.

Stephen Williams: In order to tease out what is meant by the words “substantially enclosed”, I invite the Minister to take an imaginary journey with me from Paddington station, heading west. I should say that Paddington station is substantially enclosed. It has a train shed covering the entire station concourse. Every platform has a roof over it. However, it has, of course, a big opening at the front to enable the trains to come in, and quite a large opening on to the ramp at the hotel end, to allow people to exit to get taxis or go on to the highway. Is that substantially enclosed under the Bill?
At my constituency destination of Bristol Temple Meads the station is partially covered by a roof. Platform No. 3, the main platform, has a complete roof over it, but all the other platforms are just traditional platforms. Under the Bill, would the entirety of Bristol Temple Meads be a substantially enclosed, smoke-free public place or not? If I were to go through the Severn tunnel to Cardiff central station I should find that it had no roof over it at all. It just has traditional platforms. Would it be substantially enclosed or not? Will we, under the Bill, have to carry out an assessment of every railway station to see whether it is substantially enclosed under the regulations?
The hon. Member for Westbury mentioned stadiums. If I were watching either Bristol rugby club or Bristol Rovers football club at the Memorial stadium in my constituency, and people were smoking around me, I might, because of the wind blowing about in the stadium, still be covered in cigarette smoke and still have to breathe it in, whether or not there was a roof. However, the Millennium stadium in Cardiff has a retractable roof. If it is over the stadium, the stadium is clearly completely enclosed by any definition, but if it is open it is not at all enclosed. There will be many anomalies under the Bill, even between railway stations and different types of stadiums, and people could drive a coach and horses through the legislation. Will the Minister give some commonly understood examples of what she thinks would be a substantially enclosed public space falling within the Bill, and what would be the opposite?

Caroline Flint: The point raised by the hon. Member for Bristol, West about train stations is interesting, because one of the reasons for making King’s Cross station smoke-free had nothing to do with health; the reason was safety, after the King’s Cross fire. Voluntary measures have been undertaken for a variety of reasons.
Before I deal with the points raised by the hon. Members for Northavon and for Westbury, I should mention that the speech of the hon. Member for Bristol, West was quite helpful. It made it clear that it would be difficult to specify in the Bill the different scenarios and buildings. To be fair, that has proved the same in Ireland and Scotland, which is why we will consult on draft regulations and on how we can add detail about smoke-free areas through regulations. There are several factors to take into account. Exposure is one, and another is the building itself, including matters such as its size and the size of openings. We are not trying to be difficult but, even in Ireland, where there is a total ban in certain areas and there are exemptions in others, there have been complications with definitions. So that we do not become tied up in a bureaucratic tangle, such matters are best dealt with through regulations.
Amendments Nos. 41 and 69 would add further qualifications to those set out under subsection (5), which gives regulation-making powers to define “enclosed” and “substantially enclosed”. That is a matter on which we consulted during the summer. People voiced different opinions and we are thinking about what they said. I hope that what I have to say next will clearly set out to the hon. Member for Northavon where we should move through regulation.
I understand what the hon. Gentleman tried to do by restricting the definition of “enclosed” or “substantially enclosed”, so that a definition in the regulations could not specify a figure below a half. Rather than putting such matters in the Bill, I believe that they will be properly dealt with in regulations. The amendment would put an arbitrary limit on the definition.
When we consulted in the summer, we proposed a definition that was based on south Australian legislation that used a measurement of 70 per cent., but included the roof and wall area in that calculation. Worries were expressed about that definition during the consultation. There was also an uncertain view about what else we should be doing. However, while I cannot in principle accept the amendment for the reasons that I have outlined, I am minded to follow the definition drawn up for regulations under Scottish legislation. That would set “substantially enclosed” as when openings had an area less than half the area that constituted the perimeter. I am inclined down that route at the moment. We are still discussing the issues and we will publish draft regulations.
I turn now to amendment No. 45. I shall come back to amendment No. 69. I agree with several points made by the hon. Member for Westbury about amendment No. 45. It would create a situation in which people working in membership clubs and workers providing goods or services to those clubs were not allowed to go  into areas where people were smoking. Such a rule would have consequences, for example, if there was an altercation or something else happened that the club staff had to attend to. If a fight broke out or a person was selling drugs on the premises, it would be ridiculous to prevent staff from taking action in line with their other duties and responsibilities because smoking was taking place in an area.
A decision to prohibit exposure to smoking in the bar area applies equally to private membership clubs. Such matters will therefore form part of our consultation. The hon. Member for Westbury asked what more could do to reduce exposure to second-hand smoke in those areas where smoking is not completely banned. We should deal with protection around the bar area by regulation. I am not sure that the amendment is helpful.
Amendment No. 69 suggests that, in drawing up definitions of “enclosed” and “substantially enclosed”, we should have
“regard to the excess health risk conferred on an individual by virtue of the enclosure.”
I am not sure whether it was the intention of the hon. Member for Westbury, but the amendment seems to suggest that there might be a threshold of excess health risk from second-hand smoke that could allow smoking to continue in enclosed premises and that the level of risk could be monitored under the regulations.
On several occasions, the hon. Gentleman has referred to an air quality standard that should be met, or a ventilation standard. I am not convinced that either of those options offers meaningful protection from second-hand smoke. Neither am I convinced that it is helpful, considering the direction in which we are moving in relation to smoke-free places, to come up with an arbitrary or debated conclusion on what is an adequate level of ventilation. There are many different views on that. No one is saying to private members’ clubs, nightclubs or pubs that serve only drink that they should not have ventilation on their premises. It is appropriate that they should decide that; it is not for us to try to define or regulate such matters in the Bill.

Andrew Murrison: I just want to clarify something. The purpose of my amendment is to impress on Ministers the need to base their definition in this matter on public health grounds and the evidence base, rather than on considerations—such as nuisance or amenity—of the sort that might be influencing the Liberal Democrats’ thinking when they talk about Paddington station or stadiums in Cardiff.

Caroline Flint: As I said earlier, in bringing forward the Bill we considered evidence from several sources, including evidence on the dangers to people’s health of exposure to second-hand smoke. At this point, we as a Government feel that we can act on what people told us, which was to restrict smoking in more public places and workplaces. That is the intention of the Bill. It is not a narrowly defined piece of health and safety legislation. We have been clear about that. It is about increasing people’s opportunities to work and socialise in more smoke-free environments. Every worker who does not work in a smoke-free environment will be  better protected when the legislation is passed. Even organisations that support a total ban recognise that the Bill takes us forward a step, and that it will reduce the number of deaths and illnesses caused by second-hand smoke.

Steve Webb: This has been a fruitful discussion. It is helpful to get some indication from the Minister of her latest thinking. We are heartened that there is some indication of a drift from 70 per cent. to 50 per cent. Although that is not a firm commitment, we see it as a move in the right direction that is in the spirit of our amendment, so we welcome that.
I move briefly to the Minister’s response to my hon. Friend Member for Bristol, West. We are not asking for a schedule 93 to the Bill containing a list of train stations, but we want to know what we are legislating for. We want to know whether public places such as Paddington station will be caught by the Bill. It is hard to assess whether one supports a measure if one has little feel for what will come within its scope. We are not asking for chapter and verse in the Bill, but I hope that the Minister will give us more of a feel in later sittings of the scope of what we are talking about, recognising that the fine detail will come later.
On the issue of private clubs, I accept the Minister’s point that we cannot completely stop workers from ever going into a smoky environment. What we are driving at with the amendment is whether they have to do so routinely as a condition of employment, although I accept that that is not fully conveyed by the drafting of the amendment.
The hon. Member for Westbury makes a good point with amendment No. 69 about assessing the extent of exemptions and interventions against some health benefit criteria. The Minister keeps telling us that this is not a narrow health and safety Bill, but a lot of me wishes that this bit of it were, as that would keep us focused and would get rid of some of the arbitrary exemptions. We have made some progress and have heard about some encouraging developments from the Minister, so we will not seek to press the Committee to a Division. Therefore I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

It being One o’clock, The Chairman adjourned the Committee without Question put, pursuant to the Standing Orders.

Adjourned till this day at five minutes to Four o’clock.